Repetitive strain injury (cumulative trauma disorder): causes and treatment.

BACKGROUND: The computerization of the workforce in the last two decades has led to increases in the incidence of repetitive strain injury (RSI). U.S. Workers Compensation claims made by persons disabled in the upper extremities in 1989 were estimated to be $563 million. METHOD: Through an investigation of factors that increase the likelihood of contracting an RSI in various industries, the authors suggest a relation between workplace conditions, lack of education about causes of RSI and improper use of equipment among contemporary workers. RESULTS: A medical term which analyzes the unique history and mechanism of the injury and offers a unique regimen of exercise, education, modalities and some pain management has proven to be the most effective treatment for RSI. Damage to muscle and tendon due to RSI generally cannot be surgically repaired. However, specific nerve-related disorders can be treated with surgery if other more conservative treatments prove ineffective. CONCLUSION: Through foresight and education, industries in which specific factors render workers more likely to contract RSI can begin to take steps to minimize worker susceptibility to the disorder. Those industries will face large losses due to Workers\u27 Compensation claims, disability pay, lawsuits and ultimately lower productivity

Brief review: Piriformis syndrome: Etiology, diagnosis, and management

Purpose: In this narrative review, we aim to provide the pathophysiology and diagnostic criteria of the piriformis syndrome (PS), an underdiagnosed cause of buttock and leg pain that can be difficult to treat. Based on existing evidence, frequencies of clinical features are estimated in patients reported to have PS. In view of the increasing popularity of ultrasound for intervention, the ultrasound-guided technique in the treatment of PS is described in detail. Source: A literature search of the MEDLINE® database was performed from January 1980 to December 2012 using the search terms e.g., " piriformis injection", " ultrasound guided piriformis injection", " botulinum toxin", "pain management", and different structures relevant in this review. There was no restriction on language. Principal findings: A review of the medical literature pertaining to PS revealed that the existence of this entity remains controversial. There is no definitive proof of its existence despite reported series with large numbers of patients. Conclusion: Piriformis syndrome continues to be a controversial diagnosis for sciatic pain. Electrophysiological testing and nerve blocks play important roles when the diagnosis is uncertain. Injection of local anesthetics, steroids, and botulinum toxin into the piriformis muscle can serve both diagnostic and therapeutic purposes. An ultrasound-guided injection technique offers improved accuracy in locating the piriformis muscle. Optimizing the therapeutic approach requires an interdisciplinary evaluation of treatment